Healthcare los­ing con­sumer trust through lack of price trans­parency

Modern Healthcare - - COMMENT - By Joseph Fifer In­ter­ested in sub­mit­ting a Guest Ex­pert op-ed? View guide­lines at modernhealthcare.com/op-ed. Send drafts to As­sis­tant Man­ag­ing Editor David May at dmay@modernhealthcare.com.

In 1963, Dr. Martin Luther King Jr. ral­lied sup­port for civil rights by say­ing that our coun­try could no longer af­ford the lux­ury of ad­min­is­ter­ing it­self “the tran­quil­iz­ing drug of grad­u­al­ism.” In­stead, King said, we must rec­og­nize “the fierce ur­gency of now.”

That phrase has res­onated through the years in many con­texts. The is­sue at hand is healthcare con­sumer rights, so it’s our turn. In my trav­els, I hear peo­ple say that ad­dress­ing con­sumerism is a big job that will take time. That as­sess­ment is jus­ti­fi­able. A sys­tem de­signed for trans­ac­tions be­tween busi­nesses and third-party pay­ers can’t be­come re­tail-ori­ented overnight.

Months pass, other things take prece­dence, and that nag­ging feel­ing per­sists: We should be mov­ing for­ward with con­sumerism. But some­how, it doesn’t rise to the top of the pri­or­ity list. Mean­while, third par­ties con­tinue de­vel­op­ing web­sites and apps with price data likely to be less ac­cu­rate than in­for­ma­tion di­rectly from providers or health plans. Be­fore we know it, years go by, and we have made lit­tle progress.

In fact, we are ac­tu­ally los­ing ground. We are los­ing the trust of our cus­tomers—our pa­tients, our most im­por­tant as­set—and not only from a loy­alty stand­point.

As pop­u­la­tion health man­age­ment takes hold, pa­tient en­gage­ment is crit­i­cal, es­pe­cially for those with chronic con­di­tions. Yet, new pro­pri­etary re­search con­ducted by Nielsen/Harris In­ter­ac­tive’s Strate­gic Health Per­spec­tives shows that pa­tients who need healthcare con­sumerism the most— those who have sig­nif­i­cant out-of­pocket ex­penses and are con­cerned about their abil­ity to pay—are in­creas­ingly feel­ing dis­em­pow­ered, if not down­right hope­less about the healthcare sys­tem. The num­ber of these atrisk con­sumers who re­ported feel­ing pow­er­less went up from 23% in 2014 to 31% in 2015; the pro­por­tions who said they felt re­signed, de­pressed and an­gry also in­creased.

Com­mon sense tells us that de­pressed, re­signed con­sumers are not go­ing to use trans­parency tools. Nei­ther will they make op­ti­mal healthcare de­ci­sions. They’re just not equipped to be full part­ners in their care.

We should act now to bring these dis­en­gaged con­sumers back into the fold—and to main­tain the trust of oth­ers. The first step is to change our mind­set. Let’s agree that it’s rea­son­able for con­sumers to ex­pect ac­cu­rate in­for­ma­tion about what they’re ex­pected to pay out of pocket. Let’s fur­ther agree that con­sumers shouldn’t have to hunt down in­for­ma­tion about fi­nan­cial as­sis­tance or feel any stigma about it. Fi­nally, let’s agree to rec­og­nize the fierce ur­gency of now. The longer we wait, the more we stand to lose. Once there is con­sen­sus, the ac­tion plan is straight­for­ward:

Col­lab­o­rate. No group can de­liver on price trans­parency alone. Health plans are well-equipped to pro­vide price in­for­ma­tion to their mem­bers. Con­sumers who are unin­sured or seek­ing care out of net­work will nat­u­rally look to providers for price in­for­ma­tion. If providers and health plans work to­gether, they can cover all the bases. A multi-or­ga­ni­za­tional task force con­vened by the Healthcare Fi­nan­cial Man­age­ment As­so­ci­a­tion last year came to these con­clu­sions. The re­port can be found at hfma.org/trans­parency.

Pri­or­i­tize. Ag­gre­gat­ing charge­mas­ter items into un­der­stand­able pro­ce­dure-level prices, when ap­pro­pri­ate, would be an im­prove­ment. Also, keep in mind that most uti­liza­tion typ­i­cally rep­re­sents a small per­cent­age of line items. Fo­cus ini­tial trans­parency ef­forts on com­mon pro­ce­dures or price- sen­si­tive ser­vices. One as­pect to pri­or­i­tize across the board is com­mu­ni­ca­tion. When your front­line staff talk with pa­tients, are they cov­er­ing the right top­ics? Are they con­vey­ing re­spect and em­pa­thy? Their roles have changed sig­nif­i­cantly. Make sure they re­ceive train­ing to han­dle their ex­panded re­spon­si­bil­i­ties. They are the front door of your or­ga­ni­za­tion.

Learn from the ex­perts. For most of us, con­sumer en­gage­ment is not a core com­pe­tency. Rec­og­niz­ing the lessons to be learned from re­tail, Providence Health & Ser­vices in the Pa­cific North­west re­cruited a se­nior ex­ec­u­tive from Ama­zon to help guide the or­ga­ni­za­tion’s ap­proach in this arena. Oth­ers would do well to look out­side of healthcare for ideas and ex­per­tise.

Decades ago, the U.S. auto in­dus­try was shaken out of its com­pla­cency by dis­rup­tive com­pe­ti­tion from Ja­pan. It changed the in­dus­try rapidly and for­ever. New healthcare com­peti­tors who un­der­stand the con­sumer space well are poised to meet con­sumer needs if tra­di­tional providers can’t or won’t.

That’s the fierce ur­gency of now. Those who un­der­stand history have the best chance to avoid re­peat­ing it.

Joseph Fifer is pres­i­dent and CEO of the Healthcare Fi­nan­cial Man­age­ment As­so­ci­a­tion.

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